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Propofol and Clevidipine-induced Hypertriglyceridemia
Harleen Kaur1, Premkumar Nattanamai2, Kathryn E Qualls3
1Neurology, Univeristy of Missouri, Columbia, USA.
Cureus
|October 26, 2018
Summary
Combined use of propofol and clevidipine lipid emulsions can elevate serum triglycerides and pancreatic enzymes. Careful monitoring and limiting fat intake from other sources are crucial to prevent adverse effects like pancreatitis in neurocritical care settings.
Area of Science:
- Critical Care Medicine
- Pharmacology
- Biochemistry
Background:
- Propofol and clevidipine are lipid-based medications used in neurocritical care.
- Hypertriglyceridemia and pancreatitis are known risks associated with lipid emulsions, particularly propofol.
- Limited data exists on the combined effects of propofol and clevidipine on lipid metabolism.
Observation:
- A case of a 27-year-old male with subarachnoid hemorrhage receiving prolonged propofol and clevidipine infusions.
- Calculated total caloric and fat intake from propofol, clevidipine, and enteral nutrition.
- Documented rise in serum triglyceride and pancreatic enzyme levels during combined infusion.
Findings:
- Continuous propofol and clevidipine infusions significantly increased serum triglyceride levels.
- Discontinuation of propofol led to improvement in triglyceride and pancreatic enzyme levels.
- The patient received substantial caloric and fat load from all lipid sources.
Implications:
- Combined use of propofol and clevidipine requires vigilant monitoring of serum triglycerides.
- Limiting total caloric intake from fat, including enteral nutrition, may mitigate risks.
- This case highlights the potential for additive adverse effects of concurrent lipid emulsion administration.
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